Assessment of the infarct size in high-resolution electrocardiograms

The present study was focused on high-resolution orthogonal electrocardiography (HR-OECG) analysis for assessment of the zone of necrosis after acute myocardial infarct (AMI). We examined HR-OECG recordings of 13 healthy controls, 9 patients with anterior AMI and 13 patients with inferior AMI. The AMI size was evaluated by the enzyme levels of creatine kinase-common (CPK) and its MB-fraction (CPK-MB). Multiple regression models were derived where the observed enzyme level was the dependent variable and the predictor variables were selected among the defined morphological descriptors of the QRS-T pattern. Since the measured amplitudes and durations of the QRS-T pattern for the three leads of the HR-OECG recordings depend on the AMI localization, we investigated the discriminating ability of these OECG descriptors for recognition of the two studied AMI types - anterior and inferior. The results showed that some of the OECG descriptors, which were selected in the best regression models of the enzyme fractions, were also included in the best discriminating sets. The results of this study indicate the need for further investigations of the HR-OECG potential as a fast and accurate method for assessment of the AMI size and localization.